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Sawicka-Zukowska M, Kretowska-Grunwald A, Kania A, Topczewska M, Niewinski H, Bany M, Grubczak K, Krawczuk-Rybak M. Iron Overload in Children with Acute Lymphoblastic and Acute Myeloblastic Leukemia-Experience of One Center. Cancers (Basel) 2024; 16:367. [PMID: 38254856 PMCID: PMC10814127 DOI: 10.3390/cancers16020367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
Transfusions of packed red blood cells (PRBCs), given due to an oncological disease and its acute complications, are an indispensable part of anticancer therapy. However, they can lead to post-transfusion iron overload. The study aim was to evaluate the role of ferritin as a nonspecific marker of leukemic growth and marker of transfusion-related iron overload. We performed a longitudinal study of PRBC transfusions and changes in ferritin concentrations during the oncological treatment of 135 patients with childhood acute lymphoblastic and acute myeloblastic leukemia (ALL and AML, median age 5.62 years). At the diagnosis, 41% of patients had a ferritin level over 500 ng/mL, and 14% of patients had a ferritin level over 1000 ng/mL. At the cessation of the treatment, 80% of the children had serum ferritin (SF) over 500 ng/mL, and 31% had SF over 1000 ng/mL. There was no significant difference between SF at the beginning of the treatment between ALL and AML patients, but children with AML finished treatment with statistically higher SF. AML patients had also statistically higher number of transfusions. We found statistically significant positive correlations between ferritin and age, and weight and units of transfused blood. Serum ferritin at the moment of diagnosis can be a useful marker of leukemic growth, but high levels of SF are connected with iron overload in both AML and ALL.
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Affiliation(s)
- Malgorzata Sawicka-Zukowska
- Department of Pediatric Oncology and Hematology, Medical University of Bialystok, Jerzego Waszyngtona 17, 15-274 Bialystok, Poland; (A.K.-G.); (A.K.); (H.N.); (M.B.); (M.K.-R.)
| | - Anna Kretowska-Grunwald
- Department of Pediatric Oncology and Hematology, Medical University of Bialystok, Jerzego Waszyngtona 17, 15-274 Bialystok, Poland; (A.K.-G.); (A.K.); (H.N.); (M.B.); (M.K.-R.)
- Faculty of Computer Science, Bialystok University of Technology, Wiejska 45A, 15-351 Bialystok, Poland;
| | - Agnieszka Kania
- Department of Pediatric Oncology and Hematology, Medical University of Bialystok, Jerzego Waszyngtona 17, 15-274 Bialystok, Poland; (A.K.-G.); (A.K.); (H.N.); (M.B.); (M.K.-R.)
| | - Magdalena Topczewska
- Faculty of Computer Science, Bialystok University of Technology, Wiejska 45A, 15-351 Bialystok, Poland;
| | - Hubert Niewinski
- Department of Pediatric Oncology and Hematology, Medical University of Bialystok, Jerzego Waszyngtona 17, 15-274 Bialystok, Poland; (A.K.-G.); (A.K.); (H.N.); (M.B.); (M.K.-R.)
| | - Marcin Bany
- Department of Pediatric Oncology and Hematology, Medical University of Bialystok, Jerzego Waszyngtona 17, 15-274 Bialystok, Poland; (A.K.-G.); (A.K.); (H.N.); (M.B.); (M.K.-R.)
| | - Kamil Grubczak
- Department of Regenerative Medicine and Immune Regulation, Medical University of Bialystok, Jerzego Waszyngtona 13, 15-269 Bialystok, Poland;
| | - Maryna Krawczuk-Rybak
- Department of Pediatric Oncology and Hematology, Medical University of Bialystok, Jerzego Waszyngtona 17, 15-274 Bialystok, Poland; (A.K.-G.); (A.K.); (H.N.); (M.B.); (M.K.-R.)
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Murawski M, Garnier H, Stefanowicz J, Sinacka K, Izycka-Swieszewska E, Sawicka-Zukowska M, Wawrykow P, Wrobel G, Mizia-Malarz A, Marciniak-Stepak P, Czauderna P. Parenchyma Sparing Anatomic Liver Resections (Bi- and Uni-Segmentectomies) for Liver Tumours in Children-A Single-Centre Experience. Cancers (Basel) 2023; 16:38. [PMID: 38201466 PMCID: PMC10778279 DOI: 10.3390/cancers16010038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 12/12/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
Purpose: To present a single-centre experience in bi- and uni-segmentectomies for primary liver tumours in children. METHODS This study included 23 patients that underwent (bi)segmentectomy. There were 15 malignant tumours (hepatoblastoma-13 patients), 7 benign tumours, and 1 calcifying nested stromal epithelial tumour. RESULTS The median tumour diameter was 52 mm (range 15-170 mm). Bisegmentectomy 2-3 was most frequently performed (seven patients), followed by bisegmentectomy 5-6 (four patients). The median operative time was 225 min (range 95-643 min). Intraoperative complications occurred in two patients-small bowel perforation in one and an injury of the small peripheral bile duct resulting in biloma in the other. The median resection margin in patients with hepatoblastoma was 3 mm (range 1-15 mm). Microscopically negative margin status was achieved in 12 out of 13 patients. There were two recurrences. After a median follow-up time of 38 months (range 12-144 months), all 13 patients with HB were alive with no evidence of disease. Two relapsed patients were alive with no evidence of disease. CONCLUSIONS From the available literature and data presented here, we propose that (bi)segmentectomy can become a viable surgical option in carefully selected paediatric patients and is sufficient to achieve a cure. Further studies evaluating the impact of parenchymal preservation surgery on surgical and oncological outcome should be conducted with a larger dataset.
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Affiliation(s)
- Maciej Murawski
- Department of Surgery and Urology for Children and Adolescents, Medical University of Gdansk, 80-210 Gdansk, Poland; (H.G.); (P.C.)
| | - Hanna Garnier
- Department of Surgery and Urology for Children and Adolescents, Medical University of Gdansk, 80-210 Gdansk, Poland; (H.G.); (P.C.)
| | - Joanna Stefanowicz
- Department of Pediatrics, Hematology and Oncology, Medical University of Gdansk, 80-210 Gdansk, Poland;
| | - Katarzyna Sinacka
- Department of Radiology, Medical University of Gdansk, 80-210 Gdansk, Poland;
| | - Ewa Izycka-Swieszewska
- Department of Pathology and Neuropathology, Medical University of Gdansk, 80-210 Gdansk, Poland;
| | | | - Pawel Wawrykow
- Department of Pediatric Oncology, Pomeranian Medical University, 71-210 Szczecin, Poland;
| | - Grazyna Wrobel
- Department and Clinic of Haematology, Blood Neoplasms, and Bone Marrow Transplantation, Medical University of Wroclaw, 50-425 Wroclaw, Poland;
| | - Agnieszka Mizia-Malarz
- Department of Pediatric Oncology, Hematology and Chemotherapy, Medical University of Silesia, 40-752 Katowice, Poland;
| | - Patrycja Marciniak-Stepak
- Department of Pediatric Oncology Hematology and Transplantology, Poznan University of Medical Sciences, 60-572 Poznan, Poland;
| | - Piotr Czauderna
- Department of Surgery and Urology for Children and Adolescents, Medical University of Gdansk, 80-210 Gdansk, Poland; (H.G.); (P.C.)
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Kunc M, Gabrych A, Dulak D, Hasko K, Styczewska M, Szmyd D, Nilsson K, Iwinski M, Sobocińska-Mirska A, Sawicka-Zukowska M, Krawczyk MA, Bien E. Systemic inflammatory markers and serum lactate dehydrogenase predict survival in patients with Wilms tumour. Arch Med Sci 2022; 18:1253-1261. [PMID: 36160344 PMCID: PMC9479718 DOI: 10.5114/aoms/125543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 07/19/2020] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Markers of inflammation such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) have been found to be associated with survival in cancer patients. The aim of the current study was to establish the prognostic significance of simple laboratory markers of systemic inflammation in paediatric patients diagnosed with Wilms tumour (WT). Additionally, we aimed to compare the complete blood count (CBC) parameters of WT patients and the non-oncological control group. MATERIAL AND METHODS The study group included 88 children diagnosed with WT. Clinicopathological data, as well as CBC, C-reactive protein (CRP) and lactate dehydrogenase (LDH) levels at diagnosis, were obtained. Additionally, the laboratory results of 62 healthy control paediatric patients were collected. Uni- and multivariate proportional Cox's hazard analyses were computed to create a model predicting relapse-free survival (RFS) and overall survival (OS) in the study group. RESULTS High CRP, LDH, and NLR were associated with a higher stage of WT and shorter RFS, whereas all parameters correlated with OS. In multivariate analysis, only LDH levels had adverse significance in predicting RFS. C-reactive protein and LMR retained their prognostic value in the multivariate model predicting OS. Comparing the WT group with controls, high LDH, high CRP, high NLR, and high PLR were associated with WT presence. CONCLUSIONS Preoperative LDH, CRP, NLR, PLR, and LMR have significant prognostic value in patients with WT independently of age and stage. Combined low CRP and high LMR identified the group of patients with excellent OS. Patients with high LDH were characterized by the highest risk of relapse.
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Affiliation(s)
- Michał Kunc
- Department of Pathomorphology, Medical University of Gdansk, Gdansk, Poland
| | - Anna Gabrych
- Department of Pediatrics, Hematology and Oncology, Medical University of Gdansk, Gdansk, Poland
| | - Dominika Dulak
- The English Division Pediatric Oncology Scientific Circle, Medical University of Gdansk, Gdansk, Poland
| | - Karolina Hasko
- The English Division Pediatric Oncology Scientific Circle, Medical University of Gdansk, Gdansk, Poland
| | - Malgorzata Styczewska
- The English Division Pediatric Oncology Scientific Circle, Medical University of Gdansk, Gdansk, Poland
| | - Dagmara Szmyd
- Coronary Care Unit, Cardiology Department, West Cumberland Hospital, Whitehaven, United Kingdom
| | - Kristoffer Nilsson
- The English Division Pediatric Oncology Scientific Circle, Medical University of Gdansk, Gdansk, Poland
| | - Marek Iwinski
- The English Division Pediatric Oncology Scientific Circle, Medical University of Gdansk, Gdansk, Poland
| | - Agata Sobocińska-Mirska
- Department of Pediatrics, Oncology and Hematology, Medical University of Warsaw, Warsaw, Poland
| | - Malgorzata Sawicka-Zukowska
- Department of Pediatrics, Paediatric Oncology, and Hematology, Medical University of Bialystok, Bialystok, Poland
| | - Malgorzata A. Krawczyk
- Department of Pediatrics, Hematology and Oncology, Medical University of Gdansk, Gdansk, Poland
| | - Ewa Bien
- Department of Pediatrics, Hematology and Oncology, Medical University of Gdansk, Gdansk, Poland
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Synakiewicz A, Stanislawska-Sachadyn A, Sawicka-Zukowska M, Galezowska G, Ratajczyk J, Owczarzak A, Skuza M, Wolska L, Stachowicz-Stencel T. Correction to: Plasma free amino acid profiling as metabolomic diagnostic and prognostic biomarker in paediatric cancer patients: a follow-up study. Amino Acids 2020; 53:139-141. [PMID: 33305334 DOI: 10.1007/s00726-020-02924-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Anna Synakiewicz
- Department of Pediatrics, Hematology and Oncology, Medical University of Gdansk, 7 Debinki Street, 80-211, Gdansk, Poland
| | | | | | - Grazyna Galezowska
- Department of Environmental Toxicology, Medical University of Gdansk, Gdansk, Poland
| | - Joanna Ratajczyk
- Department of Environmental Toxicology, Medical University of Gdansk, Gdansk, Poland
| | - Anna Owczarzak
- Department of Clinical Nutrition, Medical University of Gdansk, Gdansk, Poland
| | - Malgorzata Skuza
- Diagnostic Imaging Department, The Polish Red Cross Maritime Hospital, Gdynia, Poland
| | - Lidia Wolska
- Department of Environmental Toxicology, Medical University of Gdansk, Gdansk, Poland
| | - Teresa Stachowicz-Stencel
- Department of Pediatrics, Hematology and Oncology, Medical University of Gdansk, 7 Debinki Street, 80-211, Gdansk, Poland.
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Balcerek M, Schilling R, Byrne J, Dirksen U, Cario H, Fernandez-Gonzalez MJ, Kepak T, Korte E, Kruseova J, Kunstreich M, Lackner H, Langer T, Sawicka-Zukowska M, Stefanowicz J, Strauß G, Borgmann-Staudt A. Determinants of utilization of cryopreservation of germ cells in adolescent cancer patients in four European countries. Eur J Pediatr 2020; 179:51-60. [PMID: 31493021 DOI: 10.1007/s00431-019-03459-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 08/18/2019] [Accepted: 08/22/2019] [Indexed: 11/30/2022]
Abstract
Infertility is a relevant late-effect following cancer treatment; yet, a large proportion of survivors cannot recall having been informed of this risk. In an intervention study, we examined if and how supportive patient information material on fertility/fertility-preserving measures influences utilization of cryopreservation in adolescent cancer patients. The control group, recruited 03/2014-01/2016, received the usual patient education at initial diagnosis. The intervention group, recruited 04/2016-10/2017, received patient education supported by a fertility flyer and brochure. Patients and parents were each asked questions on utilization of cryopreservation in a questionnaire 3 and 6 months after initial diagnosis. Patient core and therapy data were obtained from medical records. Overall, cryopreservation rates showed no significant difference between the control (32.7%, n = 37/113) and intervention group (36.6%, n = 37/101). In the control group, cryopreservation was associated with gender (OR 0.100, CI 0.023-0.427), age (OR 1.559, CI 1.077-2.258) and recalling information on fertility protection (OR 33.663, CI 2.100-539.574); in the intervention group, cryopreservation was related to gender (OR 0.093, CI 0.026-0.330) and the estimated infertility risk (OR 43.665, CI 2.157-883.974).Conclusion: Cryopreservation rates did not overall increase following the intervention; however, the individual risk seemed to be brought into attention more: Those at risk, including younger patients, cryopreserved at higher rates.What is Known:•Infertility is a relevant late-effect following adolescent cancer.•Guidelines recommend to offer fertility protection before cancer treatment.•A relevant proportion of adolescents with cancer are not aware of this risk.•Fertility protection seems under-used in cancer patients at risk for infertility.What is New:•Information material on fertility and protection in adolescents did not increase overall rates of cryopreservation.•Cryopreservation rates were improved according to individual risk for infertility.•Our flyers and brochures on fertility in cancer patients are available in various languages.
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Affiliation(s)
- Magdalena Balcerek
- Charité - Universitätsmedizin, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
| | | | | | - Uta Dirksen
- West German Cancer Centre, University Hospital Essen Paediatrics III, Essen, Germany.,German Cancer Research Centre (DKTK), Heidelberg, Germany
| | - Holger Cario
- Department of Paediatrics and Adolescent Medicine, University Medical Centre, Ulm, Germany
| | | | | | | | | | - Marina Kunstreich
- Department of Paediatric Oncology, Haematology and Immunology, Medical Faculty, Heinrich-Heine, University of, Düsseldorf, Germany
| | | | | | | | - Joanna Stefanowicz
- Klinika Pediatrii, Hematologii I Onkologii Gdanski Uniwersytet, Gdansk, Poland
| | - Gabriele Strauß
- Helios Kliniken Berlin-Buch, Klinik für Kinder- und Jungendmedizin, Berlin, Germany
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Synakiewicz A, Sawicka-Zukowska M, Adrianowska N, Galezowska G, Ratajczyk J, Owczarzak A, Konieczna L, Stachowicz-Stencel T. Amino acid profiles as potential biomarkers for pediatric cancers: a preliminary communication. Biomark Med 2017; 11:619-627. [PMID: 28770610 DOI: 10.2217/bmm-2017-0102] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
AIM Childhood cancer remains one of the main cause of death in the pediatric population. Amino acids (AAs) level alterations in plasma are considered to play a role in carcinogenesis and further course of the disease. METHODS Seventy-seven children with cancer, including 47 with hematological and 30 with solid tumors were enrolled in this study and compared with healthy children. Twenty-two plasma-free AAs were determined by HPLC with fluorometric detection. RESULTS The results revealed significant decrease in glutamine levels for oncological patients and significant increase in aspartic acid, glutamic acid, asparagine, serine, citrulline, alanine, GABA, tryptophan, methionine, valine, phenylalanine and isoleucine levels in cancer children versus control. CONCLUSION Plasma-free AA profile as a biomarker, which combines metabolic and clinical data, as an innovative and interdisciplinary approach, may allow for faster detection of tumor occurrence, and in the future for monitoring patient during treatment, and possible prediction of cancer recurrence.
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Affiliation(s)
- Anna Synakiewicz
- Department of Pediatrics, Hematology and Oncology, Medical University of Gdansk, 80-211 Gdansk, Poland
| | | | - Natalia Adrianowska
- Department of Pediatrics, Oncology, Hematology & Diabetology, Medical University of Lodz, 90-419 Lodz, Poland
| | - Grazyna Galezowska
- Department of Environmental Toxicology, Medical University of Gdansk, 80-211 Gdansk, Poland
| | - Joanna Ratajczyk
- Department of Environmental Toxicology, Medical University of Gdansk, 80-211 Gdansk, Poland
| | - Anna Owczarzak
- Department of Clinical Nutrition, Medical University of Gdansk, 80-211 Gdansk, Poland
| | - Lucyna Konieczna
- Department of Pharmaceutical Chemistry, Medical University of Gdansk, 80-211 Gdansk, Poland
| | - Teresa Stachowicz-Stencel
- Department of Pediatrics, Hematology and Oncology, Medical University of Gdansk, 80-211 Gdansk, Poland
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Latoch E, Muszynska-Roslan K, Panas A, Panasiuk A, Sawicka-Zukowska M, Zelazowska-Rutkowska B, Zabrocka E, Krawczuk-Rybak M. Adipokines and Insulin Resistance in Young Adult Survivors of Childhood Cancer. Int J Endocrinol 2016; 2016:6349134. [PMID: 27212946 PMCID: PMC4860245 DOI: 10.1155/2016/6349134] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 03/29/2016] [Indexed: 11/18/2022] Open
Abstract
We examined the association between adipokines (leptin, adiponectin, and resistin), radiotherapy, measurement of body fat, and insulin resistance among young adult survivors of childhood cancer (CCS). Materials and Methods. Seventy-six survivors were included (mean age 24.1 ± 3.5 years). Insulin resistance (IR) was calculated using the homeostasis model assessment (HOMA-IR). The serum levels of adipokines were assayed by immunoassays. Fat mass was evaluated by DXA. Results. Mean adiponectin level and mean body FAT were higher in the examined females than in males (10009 ± 6367 ng/mL versus 6433 ± 4136 ng/mL, p < 0.01; 35.98 ± 9.61% versus 22.7 ± 7.46%, p < 0.001). Among CCS, one of 75 patients met the criteria of insulin resistance, and in 14 patients there was impaired fasting glucose. The multiple regression model for females showed that leptin/adiponectin ratio (LA ratio) significantly affected HOMA-IR (increase of 0.024 per each unit of LA ratio; p < 0.05). Radiotherapy had no effect on serum adipokines and IR. Conclusion. The observed results support the hypothesis that adiponectin might be associated with insulin resistance and it can not be ruled out that changes in the mean level of adiponectin per FAT mass or leptin/adiponectin ratio may precede the occurrence of insulin resistance in the future.
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Affiliation(s)
- Eryk Latoch
- Department of Pediatric Oncology and Hematology, Medical University of Bialystok, 15-274 Bialystok, Poland
- *Eryk Latoch:
| | - Katarzyna Muszynska-Roslan
- Department of Pediatric Oncology and Hematology, Medical University of Bialystok, 15-274 Bialystok, Poland
| | - Agata Panas
- Department of Pediatric Oncology and Hematology, Medical University of Bialystok, 15-274 Bialystok, Poland
| | - Anna Panasiuk
- Department of Pediatric Oncology and Hematology, Medical University of Bialystok, 15-274 Bialystok, Poland
| | | | - Beata Zelazowska-Rutkowska
- Department of Pediatric Laboratory Diagnostics, Medical University of Bialystok, 15-274 Bialystok, Poland
| | - Ewa Zabrocka
- Student's Scientific Society by the Department of Pediatric Oncology and Hematology, Medical University of Bialystok, 15-274 Bialystok, Poland
| | - Maryna Krawczuk-Rybak
- Department of Pediatric Oncology and Hematology, Medical University of Bialystok, 15-274 Bialystok, Poland
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8
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Muszynska-Roslan K, Krawczuk-Rybak M, Sawicka-Zukowska M, Skotnicka B. Primitive neuroectodermal tumor in 3-year-old boy with Beckwith-Wiedemann syndrome. Pediatr Blood Cancer 2007; 49:107. [PMID: 16874766 DOI: 10.1002/pbc.20991] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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9
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Krawczuk-Rybak M, Muszyńska-Rosłan K, Kitszel A, Sawicka-Zukowska M, Wołczyński S. Relationship between insulin-like growth factors (IGF-I and IGF-II), IGF-binding proteins (IGFBP-3, IGFBP-2), leptin and anthropometric parameters (height, body mass index) during antileukaemic treatment in children. Rocz Akad Med Bialymst 2005; 50:208-11. [PMID: 16358968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
PURPOSE The aim of the study was to estimate the anthropometric parameters and their relationship to serum levels of IGF-I, IGF-II, IGFBP-3, IGFBP-2 and leptin before and during intensive antineoplastic treatment for acute lymphoblastic leukaemia in children. MATERIAL AND METHODS In 46 children in median age 6.6 years (range from 1.6 to 16) we evaluated at the time of diagnosis, after protocol I and after intensive treatment, height, body mass index (BMI) and IGF-I, IGF-II, IGFBP-3, IGFBP-2 and leptin. RESULTS Height SDS lowered in successive points of analysis whereas BMI SDS rose after protocol II. IGF-I SDS was low and similar at each point, IGF-II SDS and IGFBP-3 SDS values augmented progressively and IGFBP-2 SDS was significantly elevated before treatment and lowered (but not normalized) during the therapy. Leptin SDS was elevated, especially after protocol I. CONCLUSION Leukaemia and its treatment affect directly growth factors, its binding proteins and leptin production leading to growth retardation and overweight.
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Affiliation(s)
- M Krawczuk-Rybak
- Department of Pediatric Oncology, Medical University of Białystok, Poland.
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